Ob2 Test 1

Front 1

Limb buds visualized around ___ weeks

Back 1

8 weeks

Front 2

Define Epiphyses

Back 2

Secondary ossification centers that are separated from the shaft of the long bone by a layer of cartilage

Front 3

Distal femoral epiphyses are visible by __-__ weeks.

Proximal tibial epiphyses are visible by __-__ weeks.

Back 3

32-35 weeks

34-35 weeks

Front 4

Ulna vs Radius sides:

Back 4

Ulna = Pinky finger side

Radius = Thumb side

Front 5

Tibia vs Fibula:

Back 5

Tibia is thicker & more ant

Front 6

Suspicion for dysplasia when...

Back 6

> 2 standard deviations

Front 7

Rhizomelia

Back 7

Shortening of prox portion of the bone segment (femur, humorous)

Front 8

Mesomelia

Back 8

Shortening of the middle segments (radius/ulna, tib/fib)

Front 9

Micromelia

Back 9

Shortening of entire limb

Front 10

Most Common Lethal Skeletal Dysplasia?

Back 10

Thantophoric Dysplasia: "death producing"

Front 11

Thantophoric Dysplasia: Male vs Female?

Back 11

Males more common

Front 12

Thantophoric Dysplasia: How many types & which MC?

Back 12

2 types, type I MC

Front 13

Thantophoric Dysplasia: Type I

Back 13

MC, short curved femurs and flat vertebral bodies

"Telephone Receiver" appearance of long bones

Front 14

Thantophoric Dysplasia: Type II

Back 14

Straight short femurs, taller vertebral bodies, cloverleaf skull

Front 15

Kleeblattschadel associated with :

Back 15

Cloverleaf skull

Front 16

U/S findings with Thantophoric Dysplasia:

Back 16

Micromelia

Curved/ bowed long bones

Hypo mineralization of bones

Narrow thorax : "champagne cork"

Frontal bossing

Macrocephaly

Polyhydraminos

Front 17

Most Common non-lethal skeletal dysplasia:

Back 17

Achondroplasia

Front 18

Achondroplasia: Causes/Risks

Back 18

Autosomal dominant/ spontaneous gene mutaiton

Advanced paternal age

Front 19

Describe Heterozygous Achondroplasia

Back 19

Good survival rate, normal intelligence, neurological complicaitons

Front 20

Describe Homozygous Achondroplasia

Back 20

(Rare) Lethal d/t pulmonary hypoplasia

Front 21

U/S findings of Achondroplasia

Back 21

May not be seen > 22 weeks

Rhizomelia

Macrocephaly

Trident hands

Depressed nasal bridge

Frontal bossing

Mild ventriculomegaly

Front 22

Describe Achondrogenesis

Back 22

Cartilage abnormalities= abnormal bone formation d/t hypo mineralization

May develop hydrops

Front 23

Achondrogenesis: Type I (aka)

Back 23

(AKA: Parenti-Fraccaro)

More severe

Autosomal recessive

Extreme micromelia, frontal bossing, short & thin ribs that may fracture and poor ossification of skull, spine & pelvis

Front 24

Achondrogenesis: Type II (aka)

Back 24

(AKA: Langer-Saldino)

Less severe

Autosomal dominant

Frontal bossing, Flat face w/ micrognathia, absence of rib fractures

Front 25

Describe Short Rib Polydactyly:

Back 25

Lethal, autosomal recessive

Short ribs & limbs w/ polydactyly

3 Types

Front 26

Short Rib Polydactyly: Type I

Back 26

Saldino-Noonan not associated w/ cleft lip or palate

Front 27

Short Rib Polydactyly: Type II

Back 27

Majewski Syndrome

Front 28

Short Rib Polydactyly: Type III

Back 28

Naumoff Syndrome not associated w/ cleft lip/palate

Front 29

Findings of Short Rib Polydactyly:

Back 29

Narrow thorax

Hypomineralizaton

Short ribs

Polydactyly/ Syndactyly

Micromelia

Midline facial defects (cleft lip/palate)

Front 30

Describe Asphyxiating Thoracic Dysplasia (aka)

Back 30

(AKA: Jeune's Syndrome)

Rare, autosomal recessive

Extremely narrow thorax

Rhizomelia

Polydactyly

Pelvic & renal anomalies

Front 31

Describe: Ellis-Van Creveld Syndrome (aka)

Back 31

(AKA: Chondroectodermal dysplasia)

Rare, autosomal recessive

AMISH COMMUNITY

Front 32

Findings of Ellis-Van Creveld Syndrome

Back 32

ASD

Short limbs/ ribs

narrow thorax

polydactyly

Dysplastic nails & teeth, thin hair

Abnormalities of upper lip

Front 33

OI type I

Back 33

Mild, unlikely to Ddx in utero Autosomal Dominant.

Limb bowing (Fractures after birth), normal stature

Front 34

OI Type II

Back 34

MOST SEVERE: LETHAL

Autosomal Recessive, dominant or spontaneous

Reduced echogenicity of long bones (transparent bone sign)

Multiple in utero fractures

Front 35

OI type III

Back 35

Severe

Dominant or recessive

Deformities of long bones & spine

Front 36

OI Type IV

Back 36

MILDEST FORM

Multiple fractures

Short Stature

Front 37

Describe Campomelic Dysplasia

Back 37

Rare, Autosomal dominant

Short & bowed long bones

Short trunk, bell shaped chest

Front 38

Describe Hypophosphatasia:

Back 38

Diffuse hypo mineralization d/t alkaline phosphate deficiency

Inherited: Autosomal dom or recess

LETHAL

Front 39

Findings of Hypophosphatasia:

Back 39

Mod- sev Micromelia

Fractured/ bowed/ absent extremeties

Poor ossification of cranium, supervis of brain

Small thoracic cavity

Front 40

Describe Diastrophic Dysplasia

Back 40

Rare, Autosomal Recessive

Micrognathia, kyphoscoliosis

Variable prognosis

Adults < 4 feet

Micromelia, club feet, cleft palate, short stature, earlobe deformities, hand abnormalities

Front 41

Describe Roberts Syndrome (aka)

Back 41

(AKA: Pseudothalidomide Syndrome)

Rare, Autosomal recessive

Poor prognosis

Front 42

Findings of Roberts Syndrome

Back 42

Phocomelia: Hands/feet attach to body by a short, flipper like stump

B/L cleft lip & palate

Hypertelorism

Microcephaly

Growth restriction, mental retardation

Front 43

Describe Caudal Regression

Back 43

SIRENOMELIA

Malformation of the caudal end of the neural tube

Front 44

Caudal Regression: causes/risks

Back 44

Uncontrolled diabete, single umbilical artery

Front 45

Describe Sirenomelia

Back 45

Most severe form of caudal regression

Fusion of lower extremities

Renal anomalies

oligo & pulm hypoplasia

single umbilical A

Front 46

Findings of Arthrogryposis Multiplex Congenita

Back 46

Abnormal nerve innervations as well as disorders of the muscles and connective tissue

SEVERE CONTRACTURES - stiffness

Rigid extremities, flexed arms, hypertension of knees, clinched hands, club foot

Front 47

Describe Lethal Multiple Plerygioum Syndrome

Back 47

Autosomal Recessive

Webbing across joints & multiple contractures

Front 48

Associated findings of Lethal Multiple Plerygioum Syndrome

Back 48

Cystic hygroma, micrognathia, polyhydraminos

Front 49

Describe Pena-Shokeir Syndrome

Back 49

Abnormal joint contractures, facial abnormalities, polyhydraminos, IGUR, & pulmonary hypoplasia

Assoc w/ Trisomy 18 & Rocker bottom feet

Front 50

Amelia

Back 50

Absence of 1 or more limbs

Front 51

Aplasia

Back 51

Absence of bone

Front 52

Acheiria

Back 52

Absence of 1 or both hands

Front 53

Apodia

Back 53

Absence of 1 or both feet

Front 54

Adactyly

Back 54

Absence of 1 or more digits: hands or feet

Front 55

Hemimelia

Back 55

Absence of 1 or more extremities below the elbow or knee

Front 56

Hypoplasia

Back 56

Incomplete development of the bone

Front 57

Meromelia

Back 57

Absence of part of a limb

Front 58

Phocomlia

Back 58

Absence of prox portion of extremity w/ hand or foot attached to trunk

Front 59

Polydactyly

Back 59

Extra digits

Front 60

Syndactyly

Back 60

Fused digits

Front 61

Clinodactyly

Back 61

Overlapping digits

Front 62

Ectrodactyly

Back 62

Lobster claw anomaly, cleft hand, split hand anomaly

Deficiency of central digits of the hand/foot giving the appearance of a "claw-like" conformation

Front 63

Most Common hand anomaly:

Back 63

Polydactyly

Front 64

Describe Pre-axial Polydactyly

Back 64

Located on radial (thumb) side of hand

Front 65

Describe Post-axial Polydactyly

Back 65

MC- Located on the ulnar (pinky) side of hand

Front 66

Describe Central Polydactyly

Back 66

Affects the three central digits

Front 67

Sandal Gap anomaly assoc w/

Back 67

T21

Front 68

Describe Rocker bottom feet :

Assoc w/

Back 68

Prominent heel & convex sole

assoc w/ T18

Front 69

Describe Club Foot (aka)

& assoc w/:

Back 69

(AKA: Talipes)

Foot line in same plane as lower leg

Assoc w/ chromosomal anomalies/ syndromes, MSK disorders, SPINA BIFIDA, Oligo, & multiple gestations

Front 70

What gestational age should you mean Long bones?

Back 70

12 weeks

Front 71

Growth that is > 90th % for established GA termed:

Back 71

Macrosomia

Front 72

Growth that meas <10th % is termed :

Back 72

IGUR

Front 73

Fetal growth can be meas as often as ____ or as clinically indicated

Back 73

Every 2 weeks

Front 74

Risk factors for IUGR

Back 74

Maternal HTN, smoking, Uterine anomalies, large fibroids, placental insufficiency and hemorrhage

Front 75

Possible causes of Symmetric IUGR

Back 75

Genetic growth pattern, Intrauterine infection, severe maternal malnutrition, fetal alcohol syndrome, chromosomal anomaly, severe congenital anomaly

Front 76

What is the brain sparing affect?

Back 76

Asymmetric IGUR

- Appropriate HC and BPD, but disproportionate AC

Front 77

What is the more common form of IUGR?

Back 77

Asymmetric

Front 78

Possible causes of Asymmetric IUGR:

Back 78

*Placental Insufficiency* caused by severe maternal diabetes, chronic HTN, cardiac/renal disease, abruption, multiple gestation, smoking/drugs.

Front 79

Helpful measurements to determine IUGR:

Back 79

AC

or

HC/AC ratio: increases w/ IUGR

Front 80

Noninvasive ultrasound exam that predicts the presence or absence of fetal asphyxia and risk of fetal death in antenatal period.

Back 80

BPP

Front 81

Noninvasive test that monitors the fetal heart rate and uterine contractions and is used to evaluate fetal well-being

Back 81

NST

Front 82

Requirements for full points on BPP:

Back 82

8 pts possible points:

2pts : Gross body movement (3 fetal movements in 30 min)

2pts : Tone (1 felx/extension in 30 min)

2pts: Breathing (30 sec in 30 min)

2pts: AFV (min of 2cm x 2cm)

Front 83

Describe an Acceleration in a NST

Back 83

Rise in FHR that peaks at least 15 bmp above baseline & lasts for at least 15 sec

Front 84

Describe a Reactive NST

Back 84

2 accelerations in up to a 40 min period

GOOD

Front 85

Describe a Non-Reactive NST

Back 85

Less than 2 accelerations in up to a 40 min period, a flat tracing or consistent decrease in the FHR

Front 86

When do Decelerations in a NST become an increased risk for fetal death

Back 86

Decels last longer than 60 sec and are repetitive

Front 87

What Gest Age mes AFI?

Back 87

24-26 weeks

Front 88

AFI Parameters: WNL

Back 88

5cm - 24cm

Front 89

AFI Parameters: Oligiohydraminos

Back 89

Total AFI < 5cm and LVP = 2cm

Front 90

AFI Parameters: Polyhydraminos

Back 90

Aka Hydraminos

Total AFI > 24cm and LVP of >/= 8 cm

Front 91

What are the components of an APGAR test

Back 91

Activity

Pulse

Grimace (Reflex)

Appearance

Respiration

Front 92

APGAR scores:

Normal =

Fairly low =

Critically low =

Back 92

Norm: Above 7

Fairly low: 4-6

Critically low: Below 3

Front 93

AFI/NST/BPP are most commonly scheduled for _____ time periods

Back 93

Twice weekly testing

Front 94

What is importance of MCA Doppler? What does it show?

Back 94

Predicts presence of fetal anemia and IUGR

Higher MCA = more risk for anemia

Front 95

What will MCA Dp show w/ IUGR

Back 95

- Decrease in cerebral resistance

- Low S/D ratios

- Decreased PI

Front 96

What is the importance of Uterine Artery Doppler? What does it tell us?

Back 96

Asses risk for Preeclampsia

High Resistance Index & notching may indicate risk for Preeclampsia & adverse pregnancy outcome

Front 97

S/D ratio of Uterine Artery should be less than ____

Back 97

2.6

Front 98

What is the importance of Umbilical Artery Doppler? What does it tell us?

Back 98

Increased S/D ratio indicates incr vas resistance = IUGR

Front 99

What classifies as an abnormal Umbilical A Dp?

Back 99

End Diastolic flow that is intermittently Absent, Absent, or Reversed

*Absent/ Reversed = high morality rate

Front 100

Rule of thumb for abnormal S/D ratio of Umbilical A Dp

Back 100

S/D ratio > 3.0 after 30 weeks = ABNORMAL!

Front 101

Describe the Ductus Venosus

Back 101

Narrow, trumpet-shaped vessel in the fetal liver

Connects the Umbilical vein to the IVC

Front 102

What is an abnormal Ductus Venosus Dpl? What does it indicate?

Back 102

Reversal = Abnormal

Indicates incr placental resistance in severe IGUR, or cardiac output abnormalities w/ structure cardiac dis

Front 103

What does the transparent bone sign? What is it associated with?

Back 103

Reduced echogenicity of Long bones

Osteogenesis Imperfecta Type II

Front 104

Most Common Type of Thantophoric Dysplasia

Back 104

Type I

Front 105

Most Severe Type of Achondrogenesis

Back 105

Type I

Front 106

Which disorders display a compressible calvarium:

Back 106

OI or Hypophosphatasia

Front 107

Which disorders have a Good survival rate?

Back 107

Achondroplasia (heterozygous)

Ellis-Van Creveld Syndrome

Front 108

Types of Achondrogenesis & Akas

Back 108

Penny Feels Little Sometimes

Type I : Parenti-Fraccaro = Rib fractures

Type II : Langer Saldino

Front 109

Types of Short Rib Polydactyly & Akas

Back 109

Salads Never Make News

Type I : Saldino Noonan = no clefts

Type II : Majewski

Type III : Naumoff = no clefts